Investigative Electrocardiography in Epidemiological Studies and Clinical Trials, 2007

This book on investigative electrocardiography is addressed to investigators who are using electrocardiology as a research tool in epidemiological or clinical research or in investigations on possible adverse responses of new pharmacological agents. The primary emphasis of the book is on prognostic implications of ECG abnormalities in the conditions covered, including the prevalence and incidence of ECG abnormalities in contrasting populations. We excluded from our book cardiac disorders with a relatively low population pre- lence that otherwise may be of great clinical interest. We also decided to exclude acute myocardial infarction because we had only limited resources available on this topic from our population studies and from those clinical trials in which we have personally p- ticipated in the classi? cation of trial endpoints within the framework of an ECG research center. Clinical trials are a relatively new area of electrocardiology. However, electrocard- graphy has become a most valuable research tool in clinical trials and in investigations on morbidity and mortality risk associated with various clinical and subclinical con- tions. It has also become a crucial research tool in investigating adverse cardiac events associated with administration of new drugs. Evaluation of QT prolongation plays a central role in these investigations. As a possible marker of malignant arrhythmias, it is used by regulating agencies in their decision process for approval of new pharmacolo- cal agents.

Investigative Electrocardiography in Epidemiological Studies and Clinical Trials.- Cardiac Excitation and Repolarization.- Electrocardiographic Lead Systems.- Normal and Arrhythmogenic Ionic Channel Mechanism.- Heart Rate and Heart Rate Variability.- Methodological Considerations in Heart Rate Variability Analysis.- Supraventricular Dysrhythmias.- Ectopic Ventricular Activity.- Record Length, Spontaneous Variability and Suppression of Ectopic Ventricular Complex Activity by Drugs.- Left Ventricular Hypertrophy.- Normal Standards for Cornell Voltage, Cornell Product and Sokolow-Lyon Voltage.- Prolonged Ventricular Excitation.- Old Myocardial Infarction.- Attributable Risk.- Primary Repolarization Abnormalities.- Procedures for Determination of the Spatial QRS/T Angle from Conventional ECG Measurements.- QT Prolongation and QT Dispersion — a Critical Evaluation.- Normal ECG Standards for Adults by Gender, Age, and Ethnicity.- ECG Intervals: Tables.- ECG Wave Amplitudes*: Tables.- ECG Vector Components and Spatial Magnitudes at Normalized Time Scale: Tables.- ECG Amplitudes at 10ms Intervals: Tables.- Repolarization Waveform Vectors: Tables.

Comprehensive, penetrating, critical analysis of problems in such areas as QT prolongation in clinical drug trials, left ventricular hypertrophy, myocardial ischemia/infarction, epidemiological consideration of relative risks associated with ECG abnormalities Includes supplementary material: sn.pub/extras